Tuesday, July 2, 2013

Empower Nurses to Make a Difference

Someone is finally listening to the cries of rape in the military. And his name is President Obama.

Obama threw down the gauntlet on May 24 in a commencement address at the U.S. Naval Academy: “Those who commit sexual assault are not only committing a crime, they threaten the trust and discipline that makes our military strong. That’s why we have to be determined to stop these crimes. Because they’ve got no place in the greatest military on Earth.”
Actually, I add, they have no place in any civil society. It’s about time to proactively act and implement all measures to deal with this problem for women and girls (and men and boys).
A study released by the Defense Department prior to President Obama’s speech estimated that reports of unwanted sexual contact in the military, from groping to rape, rose 37 percent in 2012, to about 26,000 cases from 19,000 the previous year.
In recent weeks, there has been a flood of troubling allegations and they come in many forms. Two members of military sexual-assault prevention units – one for the Air Force and one at the Army’s Fort Hood in Texas – have been accused of sexual assault. A sergeant at West Point was charged with secretly videotaping female cadets in the shower. And there have been many reports that superiors have advised sexually abused women to drop their charges.
President Obama’s commitment to end this abuse of women in the military has been echoed by Secretary of Defense Chuck Hagel and resulted in a variety of legislative proposals from members of Congress designed to improve the Pentagon’s handling of sex crimes.
Legislation would create sexual assault nurse examiners
While there are many different ways to confront this crisis that are under discussion, one interesting approach affecting the nursing profession was proposed in May by Rep. Dan Lipinski (D- Ill.). Lipinski’s bill would require the armed services to provide professionally trained sexual assault nurse examiners (SANE) to assist in investigations and provide specialized medical attention and care to victims. Lipinski said the SANE Deployment Act will “help give victims more confidence to come forward knowing their cases will be handled with greater professionalism and sensitivity.”

Under the bill, the nurse examiners would be available to collect evidence during the critical early stages of any sexual assault investigation and provide care for victims of sexual assault. The congressman said the position would be filled by a nurse who is qualified through education in sexual assault forensics and in how to best care for victims of sex crimes.

Nurses and other medical personnel are on the frontlines of this fight and in position to provide care and other assistance, but they clearly need the help and support of the military brass to do their jobs.  

GAO finds nurses, doctors given inconsistent guidance on handling sexual assault cases

Unfortunately, the military leadership may not be moving fast enough to deal with this problem. Earlier this year, the Government Accountability Office (GAO) released a report that found the Pentagon has not even established consistent guidelines for the treatment of injuries stemming from sexual assault.
“Military healthcare providers do not have a consistent understanding of their responsibilities in caring for sexual assault victims because the department has not established guidance for the treatment of injuries stemming from sexual assault – which requires that specific steps are taken while providing care to help ensure a victim’s right to confidentiality,” the GAO said.

As a result, the GAO said, the various military branches have their own protocols for handling sexual assault cases, and these rules sometimes conflict. The GAO reports that some bases did not give doctors or nurses directions on how to keep sexual assault cases confidential or in other instances had rules that interfered with their ability to do so. The report warned that without assurances of privacy, that “sexual assault victims who want to keep their cases confidential may be reluctant to seek medical care.”

The Pentagon surely has a great deal of work to do to put a stop to this growing problem of sexual assault against women. While there are many steps that must be taken to address this disturbing problem, nurses and other healthcare professionals must be given clear and consistent direction on how cases should be handled, the proper training and the full backing of leadership, from Washington on down to base commanders and those in charge of medical facilities.
Our job is to prevent assault, to make sure victims feels safe to report the assault and to help the victims heal. Our mission is to join the voices demanding change in the military. To do that we need to be empowered; put nurses in leadership positions to do what they do best, protect and enhance the well-being of people.

Wednesday, June 5, 2013

Violence Against Nurses

We are reading more about violence against women in different parts of the world and some are wondering whether there is an increase in violent incidences. However, I believe two of the reasons we are reading more about it are, women are responding to it more and the public is more aware of it.

Survey after survey has documented that nurses are frequently exposed to violence from patients, patients’ families and visitors that can take the form of intimidation, harassment, stalking, beatings, stabbings and shootings. Unfortunately this is not true about workplace violence against nurses.

These acts of violence however minor or major have major psychological effects on nurses who are trying to provide quality care and undermine their trust in an infrastructure that does not protect them. Recruitment and job retention of nurses suffer as a consequence. Job absenteeism has also been reported due to violent acts.

Violence in the workplace is wide-spread

One survey of 7,000 emergency room nurses taken from January 2010 to January 2011 found that 53.4 percent of nurses reported experiencing verbal abuse and 12.9 percent reported experiencing physical violence over a seven-day period.

The study by the Emergency Nurses Association found that a patient’s room was the most dangerous place for an emergency nurse. In most cases when there was an assault, the study said nurses did not file a formal report, but did notify someone.

In another report released in 2011, The Bureau of Labor Statistics said that in 2009, there were 2,050 assaults and violent acts reported by RNs requiring an average of 4 days away from work. Of the 2,050 non-fatal assaults and violent acts, 1,830 were inflicted with injuries by patients or residents; 80 were inflicted by visitors or people other than patients; 520 RNs were hit, kicked, or beaten; 130 RNs were squeezed, pinched or scratched requiring days away from work; and 30 RNs were bitten.

There is no federal standard for workplace protection against violence for nurses, although a number of a number of states have laws that require establishment of a comprehensive prevention program for healthcare employers, as well as increased penalties for those convicted of an act of violence against a nurse.

Make violence against nurses a high priority

Six years ago,  the National Advisory Council on Nurse Education and Practice issued a report on violence in the nursing profession, and came up with a number of recommendations that are still relevant today, and need to be adopted at hospitals and  other institutions across the country.

These recommendations include the establishment of  clear standards for  workplace safety; institutional support for a culture of open communication and reporting among nursing staff, faculty, health care personnel and students regarding violence in the workplace; management training in the workplace; and the availability of clearly defined support resources, such as legal and psychological services, to nurses in violent situations, or at risk of facing violent situations.

It is time that the issue of workplace violence against nurses be given a higher priority, and that health care managers take steps to better protect nurses in the workplace.

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